March 21, 2005
Other
Question from Muskegon, Michigan, USA:
My 20 year old son was diagnosed in January 2005 with type 1 diabetes after a viral infection. He is 140 pounds, 5 feet, 8 inches tall. He has normal blood pressure. He is unable to take insulin right now because of severe hypoglycemia. His morning blood sugarswere 17 to 40 mg/dl [0.9 to 2.2 mmol/L] for the past 10 days. His daytime blood sugars range from 60 to 80 mg/dl [3.3 to 4.4 mmol/L]. His nighttime is usually 250 to 300 mg/dl [13.9 to 16.7 mmol/L]. At first, everyone thought he was in his honeymoon, but the lows are way too low and are consistently low. He has had two episodes of “insulin shock” in the early morning. His A1c at time of diagnosis was 10.1. His thyroid tests were normal. He had a fasting cortisol today. What further testing should we be expecting as he currently is not safe?
Answer:
Based on your description of the situation, this is far too complicated and rare to answer without a full history and physical examination. Please go back to your diabetes team and review with them: antibody tests, growth hormone and cortisol levels, transglutaminase antibody tests, thyroid functions and insulin levels at the time of hypoglycemia.
SB